実践報告書
平成26年3月

No.26

精神障害者職場再適応支援プログラム

リワーク機能を有する医療機関と連携した復職支援

独立行政法人 高齢・障害・求職者雇用支援機構
障 害 者 職 業 総 合センター 職 業センター

はじめに㻌㻌
障害者職業総合センター職業センターにおいては、うつ病等による休職者に対し、円滑な復職を支援していくための技法を、「精神障害者職場再適応支援プログラム（㻶㼛㼎㻌 㻰㼑㼟㼕㼓㼚㻌㻿㼡㼜㼜㼛㼞㼠㻌 㻼㼞㼛㼓㼞㼍㼙：ＪＤＳＰ）」の中で開発・改良し、その成果を地域障害者職業センター等の職業リハビリテーション機関に伝達・普及してきました。㻌
本報告書は、職業リハビリテーション機関とリワーク機能を有する精神科医療機関との望ましい連携態様を構築していくことを主な目的とし、精神障害者職場再適応支援プログラム（ＪＤＳＰ）における支援技法をベースとしながら、精神科医療機関と協働して試行した復職支援の取組み結果をとりまとめたものです。㻌
㻌 本報告書を、うつ病等による休職者に対する復職支援サービスの向上に役立てていただければ幸いです。㻌
なお、この取組みは、医療法人社団雄仁会メディカルケア虎ノ門の協力を得て行ったものであり、院長㻌 五十嵐良雄先生、精神保健福祉士㻌 萩原健司先生、作業療法士㻌 森勇
人先生、保健師・産業カウンセラー・キャリアコンサルタント㻌 飯島優子先生、事務次長㻌 林俊秀先生、デイケア所長・事務長㻌 福島南先生には貴重なご意見をいただくとともに、本報告書の第 㻟 章及び第 㻢 章 㻞 の執筆の労をお取りいただきました。ここに改めてお礼申し上げます。㻌㻌
平成 㻞㻢 年 㻟 月㻌㻌
独立行政法人高齢・障害・求職者雇用支援機構㻌
障害者職業総合センター職業センター㻌 㻌㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 センター長㻌 石田㻌 茂雄㻌
㻌㻌

目次
第１章

背景と目的

１

地域障害者職業センターにおける「リワーク支援」の機能 ················································· 3２

精神科医療機関における「リワークプログラム」の機能 ······················································· 3３両機関における復職支援の機能の比較 ··············································································· 4４連携支援の目的 ························································································································ 5

第２章

ジョブデザイン・サポートプログラムの概要

１

ジョブデザイン･サポートプログラムの支援項目

２

ジョブデザイン･サポートプログラムの構成要素 ···································································· 9３

ジョブデザイン･サポートプログラムの流れ ············································································ 11

４ジョブデザイン･サポートプログラムの支援内容 ···································································· 12

第３章·································································· 9

精神科医療機関におけるリワークプログラムの現状

１

リワーク機能を持つ精神科医療機関における復職支援の現状と課題

２

メディカルケア虎ノ門におけるリワークプログラムの実際

第４章·························· 17··················································· 25

連携支援の概要

１

連携支援のスキーム

２対象者 ·········································································································································· 33

３

連携支援の流れ ························································································································ 33

４連携支援の試行状況 ················································································································ 39

第５章················································································································ 31事例検討

１事例１ ··········································································································································· 43

２事例２ ··········································································································································· 47

３事例３ ··········································································································································· 53

４事例４ ··········································································································································· 58

５事例にかかるアンケート結果 ··································································································· 62

第６章

連携支援の効用と課題

１

職業リハビリテーションの視点から ··························································································· 67

２

医学的リハビリテーションの視点から ······················································································ 68

３まとめ（今後の展望と課題） ······································································································ 70

資料編
資料 1

ジョブデザイン･サポートプログラムのご案内 ··························································· 77

資料 2

ジョブデザイン・サポートプログラムを希望される方へ～初回相談から正式利用までの流れ～ ····························································· 81

資料 3ジョブデザイン・サポートプログラムのご案内～雇用事業所の方へ～ ·························································································· 82

資料 4

職業センター利用申請者に係る主治医の意見書 ················································ 83

資料 5

職業センタープログラム受講申請書 ········································································· 86

資料 6Ｍ－ストレス・疲労アセスメントシート（Ⅳ）本人用 ··················································· 87

資料 7生活リズム表 ··················································································································· 103

資料 8

ジョブデザイン･サポートプログラム利用者に係る情報提供について(依頼) ···· 104

資料 9情報提供書 ···················································································································· 105

資料 10 ジョブデザイン・サポートプログラムの実施に係る職業リハビリテーション計画 · 106
資料 11 ジョブデザイン･サポートプログラム利用者に係る情報提供について ················ 107